The various method have been used in reconstruction of the anophthalmic socket. Dermis-fat graft as an orbital implant is a relatively new approach. Dermis-fat graft restores the volume lost by enucleation, gives additional conjunctival lining and is permanent, with a minimal chance of absorption. Dermis-fat graft was used in reconstruction of an ophthalmic socket in our hospital. We found it successful procedure in case of primary enucleation, because it is permanent and it preserves the conjunctiva.
Absorption ; Conjunctiva ; Orbital Implants ; Transplants*

The purpose of this paper is to investigate the difference in concentration of 0.53% betamethasone in aqueour humor after betamethasone subconjunctival injection on upper and lower fornix after cataract extraction. A total of 8 rabbits were used. Cataract extractions were performed with the cryoprobe. After 6 hours, 0.53% betamethasone was subconjunctivally in upper fornix of the left eye and injected in lower fornix of the right eye. The control group of 3 rabbits underwent with the same procedures but the without lens delivery. the concentration of 0.53% betamethasone in aqueous humor was measured with HPLC(High Performance Liquid Chromatograph) after fine needle aspiration of aqueous humor. The results obtained were as follows. 1. In 5 eyes of the control group in 3 rabbits, 0.53%betamethasone was injected subconjunctivally on the lower fornix. The mean concentration of 0.53% betamethasone in aqueous humor was 0.544 +/- 0.0818 microgram/ml. 2. After 0.53% betamethasone subconjunctival injection on upper fornix after lens extraction, the mean concentration of 0.53% betamethasone in aqueous humor was 0.318 +/- 0.0117 microgram/ml. 3. After 0.53% betamethasone subconjunctival injection on lower fornix agter lens extraction, the mean concentration of 0.53%betamethasone in aqueous humor was 0.702 +/- 0.0332 microgram/ml. 4. The mean concentration of the betamethasone in aqueous humor after 0.53% betamethasone subconjunctival injection on lower fornix after lens extraction was significantly higher than on upper fornix(p<0.05).
Aqueous Humor* ; Betamethasone* ; Biopsy, Fine-Needle ; Cataract Extraction ; Rabbits

To study the isolation and purification and proliferation of the cell in cell culture system, and to develop an improved culture method by a modified cell isolation technique and modified culture medium. The RPE cells were cultured in 3 different mediums: type I(MEM medium with 20% FCS) type II(F-10 medium with 20% FCS) and type III(DMEM medium with 10% FCS, EGF, hydrocortisone, insulin, ethanolamine, phosphoethanolamine, chorea toxin, triiodotyronine, adenine, transferrin and BPE). We compared population doubling(P.D.), population doubling time(P.D.T), morphologic changes and phagocytic activity during a 7week period. Rapid proliferation and high purity of retinal pigment epithelial cells(RPE cells) showed in type III culture medium. Type III culture medium presented the best results in P.D., P.D.T. and cell purification. In type III culture medium, single RPE cells produced about 6 X 10(7) RPE cells in the 7week period and morphology and phagocytic activity were well maintained, when UV-B irradiation at RPE was used to produce melanin, it had no effect, but the RPE cell was inhibited by UV-B irradiation. This improved culture method for RPE cells will provide a good in-vitro model for the studies of biochemistry, cellular function of the RPE cell, as well as its clinical application in eye disease.
Adenine ; Biochemistry ; Cell Culture Techniques ; Cell Separation ; Chorea ; Epidermal Growth Factor ; Epithelial Cells* ; Ethanolamine ; Eye Diseases ; Hydrocortisone ; Insulin ; Melanins ; Retinaldehyde* ; Transferrin

Bacterial endophthalmitis is an ocular emergency that requires rapid diagnosis and therapeutic decision making. The introdection of intravitreal injection of antibiotics has been a major advancement because it has resulted in a marked improvement in visual outcome. The intravitreal injection of steroids may be potentially useful in the treatment of endophthalmitis and other ocular inflammatory diseases. Forty eyes of pigmented rabbits were used, and divided into two groups. Group I was eyes without vitrectomy. In the right eye, 100 microliter of 1mgvancomycin, 400 microliter amikacin and 400 microliter dexamethasone injected was done. Group II was eyes with vitrectomy and lensectomy. At 2 weeks after lens and vitreous removal, rabbit eyes received an injection of a combination of 1mg vancomycin, 400 microliter amikacin and 400 microliter dexamethasone in right eye and BSS in left eye. The effect of combination injection was examined by light and transmission, scanning electron microscope at 3 days, 1 week, 2 weeks and 6 weeks following injection. The injection of combination without vitrectomy produced no toxicity. After injections of either combination or BSS after vitrectomy, macrophages were observed on the surface of retinal pigment epithelium and disorganized outer segments. This finding seems to be produced by vitrectomy procedure rather than drug toxicity. These results supports the hypothesis that the injection of these combinations is not toxic to aphakic/vitrectomized eyes.
Amikacin ; Anti-Bacterial Agents ; Decision Making ; Dexamethasone* ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Emergencies ; Endophthalmitis ; Intravitreal Injections ; Macrophages ; Rabbits ; Retinal Pigment Epithelium ; Steroids ; Vancomycin ; Vitrectomy*

OBJECTIVE: We report an evaluation of incidence of the traumatic disc herniation and an effect of early closed reduction without prior magnetic resonance(MR) imaging in cervical spine fracture-dislocation injury. METHODS: The medical records and radiologic images of twenty consecutive traumatic cervical spine injury from the C2-3 to C7-T1 were reviewed. The disc injury on MR images was divided into two category: a herniation defined as deforming the thecal sac or nerve root and a disruption defined as a disc with high T2-weighted signal characteristics. Closed reduction was attempted in all patients and neurologic status was measured on admission and following reduction. MR image was obtainted within three days after early closed reduction. RESULTS: Early closed reduction by Gardner-Wells skeletal traction and serial plain radiography was achieved in 90% of patients and there was no associated neurological deterioration after reduction. The incidence of disc injury at the level of the fracture subluxation on the postreduction MR images was 60%(herniation-30%, disruption-30%), but the presence of disc herniation or disruption did not affect the degree of neurological recovery, as measured by American Spinal Injury Association(ASIA) motor score and the Frankel scale following early closed reduction. The average ASIA motor score prior reduction was 48.4 compared with 62.5 following reduction. CONCLUSION: Although disc herniation and disruption can occur following traumatic cervical fracture-dislocation, the actual incidence of neurological deterioration following early closed reduction is rare. Therefore, immediate closed reduction using traction in patients with any neurological deficit can be safe and effective before MR imaging.
Asia ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Medical Records ; Radiography ; Spinal Injuries ; Spine ; Traction

Kissing aneurysms are very rare with only a few cases having been previously reported in the literature. We report a case of aneurysms arising from bilateral distal anterior cerebral arteries. A 56-year-old man was admitted to our hospital with subarachnoid hemorrhage. CT angiogrms and cerebral angiograms showed mirror image aneurysms touching each other were located at bilateral distal anterior cerebral arteries. During operation we confirmed the aneurysms were in contact.
Aneurysm* ; Anterior Cerebral Artery* ; Humans ; Middle Aged ; Subarachnoid Hemorrhage

OBJECTIVE: 6R-Tetrahydrobiopterin(BH4) is a cofactor for the aromatic amino acid hydroxylases which is essential for the biosynthesis of catecholamines and serotonin. It also acts as a cofactor for nitric oxide synthase, and stimulates the release of some neurotransmitters such as dopamine, serotonin, acetylcholine and glutamate. Recently, it has been reported that BH4 could induce cellular proliferation and enhance neuronal survival. This study was performed to investigate the antioxidative effect of BH4 on the various oxidative insults in mouse cerebral cortical cell cultures. METHODS: Iron ion(FeCl2), zinc ion(ZnCl2), sodium nitroprusside(SNP) and buthionine sulfoximine(BSO, a glutathione depletor) were used as oxidants. Cell death was assessed by measurement of lactate dehydrogenase efflux to bathing media at the end of exposure. RESULT: All 4 oxidants induced neuronal cell death associated with cell body swelling, which was markedly inhibited by trolox(100nM), a vitamin E analog. BH4(10-100nM) markedly inhibited the neuronal cell death induced by all 4 oxidants(20nM Cu2+, 20nM Zn2+, 1nM SNP or 1mM BSO). However, BH4 failed to inhibit the neuronal cell death induced by 24hr exposure to 20nM NMDA. CONCLUSION: These results suggest that BH4 has antioxidative action independently of any actions of enzyme cofactor.
Acetylcholine ; Amino Acids, Aromatic ; Animals ; Baths ; Catecholamines ; Cell Culture Techniques ; Cell Death ; Cell Proliferation ; Dopamine ; Glutamic Acid ; Glutathione ; Iron ; L-Lactate Dehydrogenase ; Mice* ; Mixed Function Oxygenases ; N-Methylaspartate ; Neurons* ; Neurotransmitter Agents ; Nitric Oxide Synthase ; Oxidants ; Serotonin ; Sodium ; Vitamin E ; Vitamins ; Zinc

Following kainate (KA)-induced epilepsy, rat hippocampal neurons strongly ex-press immediate early gene (IEG) products, i.e., c-FOS and c-JUN, and neural stress protein, HSP72. Prolonged expression of c-JUN and c-FOS 48 hr after cerebral ischemia has been underwent delayed neuronal death. However, it is not yet clear whether IEGs actually assume the essential roles in the cell death process or simply as a by-product due to external stimuli because of the prolonged expression of c-FOS, more than one week, on intact CA2 neurons of the hippocampus in a KA-induced epilepsy model. This study investigated the relationships between prolonged expression of c-JUN and hippocampal neuronal apoptosis in a KA-induced epilepsy model. Epileptic seizure was induced in rats by a single microinjection of KA (1g/l) into the left amygdala. Characteristic seizures and hippocampal neuronal injury were developed. The expression of c-JUN was evaluated by immunohistochemistry, and neuronal apoptosis by in situ end labeling. The seizures were associated with c-JUN expression in the hippocampal neurons, of which the level showed a positive correlation with that of apoptosis. Losses of hippocampal neurons, especially in the CA3 region, were partly caused by apoptotic cell death via a c-JUN-mediated signaling pathway. This is thought to be an important component in the pathogenesis of hippocampal neuronal injury via KA-induced epilepsy.
Animal ; *Apoptosis ; Epilepsy, Temporal Lobe/chemically induced/*metabolism/pathology ; Hippocampus/*chemistry/pathology ; Immunohistochemistry ; Kainic Acid/*toxicity ; Male ; Proto-Oncogene Proteins c-jun/*analysis ; Rats ; Rats, Wistar

OBJECTIVE: Middle cerebral artery occlusion(MCAO) has widely been used to produce ischemic brain lesions. The lesions induced by MCAO tend to be variable in size because of the variance in the collateral blood supply found in the mouse brain. To establish a less invasive and reproducible focal ischemia model in mice, we modified the technique used for rat photothrombosis model. METHODS: Male C57BL/6 mice were subjected to focal cerebral ischemia by photothrombosis of cortical microvessels. Cerebral infarction was produced by intraperitoneal injection of Rose Bengal, a photosensitive dye and by focal illumination through the skull. Motor impairment was assessed by the accelerating rotarod and staircase tests. The brain was perfusion-fixed for histological determination of infarct volume four weeks after stroke. RESULTS: The lesion was located in the frontal and parietal cortex and the underlying white matter was partly affected. A relatively constant infarct volume was achieved one month after photothrombosis. The presence of the photothrombotic lesion was associated with severe impairment of the motor performance measured by the rotarod and staircase tests. CONCLUSION: Photothrombotic infarction in mice is highly reproducible in size and location. This procedure can provide a simple method to produce cerebral infarction in a unilateral motor cortex lesion. In addition, it can provide a suitable model for study of potential neuroprotective and therapeutic agents in human stroke.
Animals ; Brain ; Brain Ischemia* ; Cerebral Infarction ; Humans ; Infarction ; Injections, Intraperitoneal ; Ischemia ; Lighting ; Male ; Mice* ; Microvessels ; Middle Cerebral Artery ; Motor Cortex ; Rabeprazole ; Rats ; Rose Bengal ; Skull ; Stroke

OBJECTIVE: Water-tight closure of the dura in extracranial-intracranial (EC-IC) bypass is impossible because the superficial temporal artery (STA) must run through the dural defect. Consequently, subdural hygroma and subcutaneous cerebrospinal fluid (CSF) collection frequently occur postoperatively. To reduce these complications, we prospectively performed suturing of the arachnoid membrane after STA-middle cerebral artery (STA-MCA) and evaluated the clinical usefulness. MATERIALS AND METHODS: Between Mar. 2005 and Oct. 2010, extracranial-intracranial arterial bypass (EIAB) with/without encephalo-myo-synangiosis was performed in 88 cases (male : female = 53 : 35). As a control group, 51 patients (57 sides) underwent conventional bypass surgery without closure of the arachnoid membrane. Postoperative computed tomography (CT) scan was performed twice in three days and seven days later, respectively, for evaluation of the presence of subdural fluid collection and other mass lesions. RESULTS: The surgical result was excellent, with no newly developing ischemic event until recent follow-up. The additional time needed for arachnoid suture was five to ten minutes, when three to eight sutures were required. Post-operative subdural fluid collection was not seen on follow-up computed tomography scans in all patients. CONCLUSION: Arachnoid suturing is simple, safe, and effective for prevention of subdural fluid collection in EC-IC bypass surgery, especially the vulnerable ischemic hemisphere.
Arachnoid* ; Cerebral Arteries ; Cerebral Revascularization ; Cerebrospinal Fluid ; Female ; Follow-Up Studies ; Humans ; Membranes* ; Prospective Studies ; Subdural Effusion ; Sutures ; Temporal Arteries